2019 年第 6 期 第 14 卷

实时荧光核酸恒温扩增检测技术检出肺炎支原体RNA阳性儿童流行病学及实验室检查特点分析

Epidemiological and laboratory characteristics of children with positive results of mycoplasma pneumoniae RNA by simultaneous amplification and testing

作者：渠滕田文君王明辉刘义庆刘春梅邱旸张庆崔朝杰

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单位：250000济南，山东大学附属省立医院临床检验医学部

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• 摘要：

• 【摘要】目的    了解山东地区儿童肺炎支原体(MP)感染的病原体检出率及流行特征，并分析实时荧光核酸恒温扩增检测技术（SAT）检出MP-RNA阳性患儿的实验室检查特点，为临床诊断及预防提供参考。方法    选取2017年1—12月山东大学附属省立医院因急性呼吸道感染诊断收入院的患儿604例，利用SAT行MP-RNA检测并对其流行病学特点及实验室指标进行分析。结果    604例患儿中MP核酸检测阳性109例，阳性率为18.0%。女性患儿MP核酸检测阳性率与男性患儿比较［22.0%(40/182)比16.4%(69/422)］，差异无统计学意义（P＞0.05）。0～3岁、4～7岁、8～14岁患儿MP核酸阳性率分别为10.6%（46/436）、41.2%（49/119）、28.6%（14/49），不同年龄患儿间MP核酸阳性率比较差异有统计学意义（P＜0.05）。春季（3～5月）、夏季（6～8月）、秋季（9～11月）、冬季（12～2月）收治患儿MP核酸阳性率分别为9.0%(13/144)、17.1%（19/111）、29.6%（60/203）、11.6%（17/146），不同季节患儿MP核酸阳性率差异有统计学意义（P＜0.05）。109例MP核酸阳性患儿中C反应蛋白升高44例（40.4%），正常65例（59.6%）。109例MP核酸阳性患儿血常规异常主要表现为白细胞计数升高（53例，占48.6%）、红细胞计数降低（30例，占27.5%）、血红蛋白降低（47例，占43.1%）、血小板计数升高（59例，占54.1%），其中有7例MP核酸阳性患儿血常规正常。109例核酸阳性患儿中36例送检细胞免疫功能，其中17例细胞免疫功能正常；3例CD+16CD+56升高，7例降低；15例CD+19升高，1例降低；5例CD+3降低；11例CD+3CD+4降低；2例CD+3CD+8升高。结论    MP感染与年龄和季节有很大关系，与性别的关系不大，根据本地区的发病特点，制定必要的预防措施对疾病的防治有很大帮助；MP-RNA检测能够及时准确地判断MP的感染情况，其他实验室检查能为MP的诊断提供参考，对更加深入地了解MP有一定帮助。

• 【Abstract】Objective    To investigate the prevalence and epidemiological characteristics of mycoplasma pneumoniae(MP) infection in children in Shandong Province; to analyze the characteristics of laboratory tests in MP RNA-positive children detected by simultaneous amplification and testing（SAT） and provide references for clinical diagnosis and prevention. Methods    A total of 604 children with acute respiratory infection admitted to Shandong Provincial Hospital Affiliated to Shandong University from January to December 2017 were enrolled. MP RNA was tested by SAT. Epidemiological and laboratory characteristics were analyzed. Results    There were 109 MP RNA-positive children and the positive rate was 18.0%. MP RNA-positive rate was 22.0%（40/182） in female and 16.4%（69/422） in male（P＞0.05）. There was a significant difference of MP RNA-positive rate among children aged 0-3 years［10.6%（46/436）］, 4-7 years［41.2%（49/119）］ and 8-14 years［28.6%（14/49）］(P＜0.05). MP RNA-positive rates in spring, summer, autumn and winter were 9.0%(13/144), 17.1%（19/111）, 29.6%（60/203） and 11.6%（17/146）, respectively; there was a significant difference among seasons(P＜0.05). Among the 109 patients with positive results of MP RNA, C-reactive protein increased in 44 cases(40.4%) and it was normal in 65 cases(59.6%); white blood cell count increased in 53 cases(48.6%); red blood cell count decreased in 30 cases(27.5%); hemoglobin decreased in 47 cases(43.1%); platelet count increased in 59 cases(54.1%); 7 children showed normal results of blood routine test. Seventeen of 36 children had normal cellular immune function; CD+16CD+56 increased in 3 cases and dropped in 7 cases; CD+19 increased in 15 cases and dropped in 1 case; CD+3 dropped in 5 cases; CD+3CD+4 dropped in 11 cases; CD+3CD+8 increased in 2 cases. Conclusions    MP infection is associated with age and season but not with gender. Effective preventive measures should be made for the prevention and treatment of MP infection based on significant characteristics of the disease in different region. MP RNA testing is helpful for the accurate assessment of MP infection; laboratory assistant examination can provide necessary references for the diagnosis.